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ARFID: It's Not Just "Picky Eating"





You know the drill. It's dinnertime, you've spent the past 40 minutes prepping a meal, and your kid plunks down in his seat and sighs heavily. You brace yourself for what you know comes next. Your child yells, "You KNOW I don't like potato soup! I'm not eating this!" and storms away from the table. While this may sound ungrateful or inflexible, it is possible that your child is struggling with a very real aversion to certain foods.


Or maybe you're the one struggling. Whenever you get invited out to dinner with friends you're excited, but you also have to scan the restaurant menu online in advance to see what "safe food" options are available ... and you're dreading hearing people ask, "Aren't you going to eat anything?" or "OMG you don'l like sushi?!?" If you're currently a teenager or adult, odds are extremely high that you were called a "picky eater" as a child and you may have even been shamed or chastised for your sensitivities around food.


If it's pervasive and distressing, it's most likely not just "picky eating "and it's not your fault.

And it's not your child's fault.



What exactly is ARFID?


Avoidant Restrictive Food Intake Disorder, or ARFID, is a complex eating disorder characterized by a person limiting the amount or variety of food they eat, often leading to significant nutritional deficiencies and impairments in daily functioning. It stands apart from other eating disorders such as anorexia or bulimia because the food avoidance or restriction isn’t motivated by body image concerns. Instead, there are three major motivations contributing to ARFID symptoms:


  • Lack of interest in eating

  • Sensory sensitivity

  • Fear of aversive consequences of eating (such as a fear of choking or vomiting)


Who can have ARFID?


While ARFID is commonly cited as occurring in children, anyone can experience ARFID symptoms, even teens and adults. There is a notable occurrence of ARFID in autistic people. It is also important to note that ARFID is a newer concept in the mental health and eating disorder treatment world, so it is highly likely that ARFID was overlooked in your childhood if you are now an adult.


Okay, but what does that actually look like?


Often ARFID can look like what we call “picky eating,” though this term can be diminishing to the very real distress (and health consequences) that ARFID causes. People with ARFID can feel an intense aversion or even fear of food or specific types of food. It may be that the texture, smell, or color of the food is particularly off-putting. They may be afraid of choking on food or feel like they are going to be sick when eating. Sometimes lack of interest in food can mean they forget or skip meals. They may suddenly feel full before meals or after just a few bites. Folx with ARFID may have a list (formal or informal) of a few “safe foods” they can tolerate, but struggle to eat other kinds of foods. Difficulty eating due to ARFID symptoms can cause a lot of stress and may cause those with this condition to avoid eating around others. 


Do I have ARFID? Or does my child have ARFID?

You may find yourself wondering if you, or your child, might have ARFID. Some ways to tell if eating habits are disordered, particularly if they are ARFID-related, include:


  • Avoiding and entire food group, "I don't eat vegetables."

  • Only eating foods of certain brands or of very specific varieties of foods, "I only like Wendy's fries" or "I only like Cool Ranch Doritos" or "I don't like chocolate frosting, I only like white."

  • Anxiety around new foods, which can look like refusal or "defiance" when presented with new foods, including leaving the table or becoming tearful or angry.

  • Anxiety in adults may look like avoiding new restaurants, missing social events, packing "safe foods" on outings.

  • Fears about choking, vomiting, or thinking / saying "My stomach hurts" after eating

  • This restrictive eating or avoidance of certain foods is causing weight loss

  • There is reliance on supplemental nutrition (drinking meal replacement smoothies, for example)

  • There is generally a lot of distress and anxiety around food and mealtimes that affects your ability to go about your daily life


Therapy for ARFID in Asheville, North Carolina


ARFID can cause physical and emotional distress that can make daily life difficult. Fortunately, therapy can help and recovery is possible! Treatment options may include exposure therapy and cognitive restructuring to process beliefs and sensations around food in order to reduce your anxiety and grow your list of “safe foods." Occupational Therapy (OT) is often involved in an ARFID treatment plan.


Parents can also experience a great deal of relief once they have support in place for themselves as they learn more about ARFID, adjust their ways of thinking about food, and find new ways to connect with their child.


If you or your child are struggling with ARFID symptoms, please know that recovery is possible.

At Flourish, we have therapists who are ready to help you find peace at mealtimes again. 

If you’re interested in learning more or scheduling an appointment, email jill@flourishasheville.com or call 828-532-6717 to get started.

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